The 1991 collapse of the Soviet Union and the subsequent withdrawal of its assistance to Mongolia plunged the country into economic crisis. This led to an urgent need for socioeconomic reforms, including a reshaping of the country’s health system. Since then, with support from the Asian Development Bank (ADB), Mongolia has brought about major changes to its health care system, including in hospital and primary health care (PHC), health care financing, and medicines regulation.Mongolia’s 3.3 million people are better served than ever by the current health system, but much remains to be done. The government’s experiences, including the many challenges it has faced on the road to reform, hold important lessons for other countries, particularly former socialist countries, which are experiencing a similar transition to a market economy. Mongolia’s experiences encompass the challenges of how to organize, finance, and manage a modern health care system, providing equitable access to good quality health care for all.Since the early 1990s, ADB has been a consistent supporter of the Government of Mongolia on its journey of health system reform. This support has been in the form of a series of multiyear health sector reform programs. These cover all aspects of primary care, hospital care, health care financing reform, and medicines regulation. In addition, ADB has provided targeted technical assistance to address specific issues, such as strengthening health insurance,1 and improving access to affordable medicines in public hospitals.2